Nutrition articles

LMRC Research Aims to Help Deployed Women > Landstuhl Regional Medical Center > Articles

In 2021, nearly 230,000 women were on active duty across all military services. Today’s global threats, radical terrorism, and projected future battlespaces have led to a requirement for more lethal force.

Historically, creating a more lethal force involved the male combatant. The need for combatants to operate in hostile environments, where it is culturally inappropriate for men to engage with women and children, in addition to recent legislation that has diversified military professions and specialties, has opened the door to women qualified for combat service – on , small mission warfare teams (i.e., the Army Cultural Support Team [CST]Marine Women Engagement Team [FET]).

Serving as a combatant in any military branch and profession/specialty requires solid training and high deployment rates. Serving in austere environments presents gender-specific health issues for female combatants, which often cannot be addressed quickly for a variety of reasons. These challenges usually appear as urogenital health issues.

To combat delays in care, a team of female health care providers and researchers at Landstuhl Regional Medical Center aims to expand Department of Defense-wide education and training for female combatants in austere environments and also launch an innovative self-test, self-diagnosis and self-treatment kit to help women detect and treat urogenital infections.

Urogenital health issues include any health condition that affects the urinary and genital tract. It is not the deployment that is associated with increased risk, rather it is the austerity of the environment. Some environmental challenges for the female combatant include the dwindling or even non-existent water, sanitation and hygiene resources. Lack of resources can lead to changes in health, hygiene practices and behaviors. These changes are directly related to an increased risk of urogenital infections. Additionally, these health risks require confidentiality and appropriate early detection and intervention, which can be difficult to achieve in deployed environments. Other risks involve overcoming the demands of the body by depriving it of basic necessities such as intentional dehydration to avoid urination. In addition, these deployed women report resorting to urine in plastic bottles and bags, or wearing disposable briefs. These examples of poor health and hygiene practices and behaviors increase the risk of common urogenital infections such as urinary tract infections, bacterial vaginosis, and vaginal yeast infections.

From 2008 to 2013, these urogenital infections were reported as one of the top five reasons for all medical contacts and one of the top seven reasons for all medical evacuations from deployment locations. Female combatants also reported feeling embarrassed to seek treatment for urogenital symptoms and described fear and anxiety of being falsely accused of engaging in sexual activity or being promiscuous.

The kit offered is an example of the frontline medical care available to our female combatants. It is anticipated that such a kit, containing diagnostic and other innovative components, would encourage and improve the early detection and treatment of common urogenital infections in female combatants. Early detection and treatment will keep female fighters healthy, mentally prepared and physically trained. The innovative kit would also contain a rapid self-detection test designed to detect yeast infections of the vulva and vagina, a first of its kind in women’s healthcare.

To date, no such Food and Drug Administration-approved rapid test is available on the US market. Ongoing, high profile, multi-site clinical trials are currently underway to gain FDA approval for over-the-counter use. The following military treatment facilities are participating in the trials: Landstuhl Regional Medical Center (LRMC); San Diego Navy Medical Readiness and Training Command (NMRTCSD); Womack Army Medical Center (WAMC); and Navy Medicine Readiness Training Command Portsmouth (NMRTCP).

At the LRMC Women’s Health Clinic, all intended recipients of gynecological care who meet study criteria will be offered the opportunity to participate.